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6 months of bloody diarrhea – what is the cause? A mysterious patient




A man should go to the bathroom up to 15 times a day. He suffers from bloody diarrhea. For three months he endures this until he visits the home. Doctors can make negative bacterial forms. He still prescribes a wide range of antibiotics to patients for 7 days. However, 67 will not be good.

He has to wait three more months before he can get medical support again: he now reports to Dijon-Burgundy University Hospital emergency room. There are additional problems besides diarrhea. The man had a fever for two days. Also, his epigastric pain hurts. He tells the doctor that he lost about 5kg since the complaint began.

The doctor says the patient is taking chronic hypertension medication. He retires and lives with his partner.

The position of the pain in the epigastrium allows the doctor to resolve the problem. However, the man has no jaundice that can be associated with liver disease. The institution was also not pathologically expanded, reporting the Capucine Martins team in the "BMJ Case Report" journal.

Blood tests have shown that leukocyte counts increase and so-called C-reactive proteins increase. Both are talking about the infection his body is fighting.

Liver abscess

Your doctor will look at the abdomen and pelvis using a computed tomography. His bowel shows signs of chronic inflammation. In the liver, we find two abscesses about 6-7 cm in diameter. In these, they suck red liquid.

At this point they can not say for sure the cause of the abscess. Most are the result of bacterial infections in the gastrointestinal tract.

The possibility is small, but you may think that the bacteria attacked the heart and then reached the liver through the bloodstream. And finally, the doctor can not rule out that other pathogens are behind the complaints instead of bacteria.

Additional testing should clarify this. Therefore, bacteria can not be detected in the blood. There is no typical bacterial diarrhea on stool samples.

Even liquids from liver abscesses seem to have no bacteria. However, doctors can prove that they have the genetic material of the pathogen. It is a single cell, an amoeba Entamoeba histolytica. This is confirmed by an additional test. He is suffering from an extremely rare disease in Europe – amoebic erythrocytosis. Single celled organisms colonize the field and complain. In addition, they are responsible for the abscess in the liver. In other words, it is not the typical result of E. histolytica infection.

How was he infected?

Now doctors want to know where the person is infected with amoebas. In general, people affected by Europe were tropical or subtropical. But a 67 – year – old young man has never seen him outside Europe.

His partner, however, was in the area where amebic dysentery occurred and includes India, Vietnam and South America. In addition, she used to go to a partner with an Amebic disability. She did not have symptoms on her own, but she was tested at the hospital. This indicates that E. histolytica infection does not cause any symptoms in 90% of people, the German Tropical Medicine Society reported in the Guidelines for Disease Treatment. However, affected people can remove pathogens and infect other pathogens. In most cases, hygiene is not good and contaminated drinking water is spread like amoeba. Parasites can also be transmitted during sexual intercourse. Perhaps the 67-year-old French.

This antibiotic is not helpful to Amoeba immediately – the person who received the first antibiotic on suspicion of bacterial infection. Instead, he gets treatment for this pathogen. Within 48 hours, adultery sinks, diarrhea disappears, and laboratory readings return to normal levels. His partner is also taking medication.

After two months of follow-up, the man is healthy and no more signs of pathogens are detected.


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